As the US population ages, Alzheimer's disease and related disorders (ADRD) will present an emotional and financial burden to an increasing number of families and the U.S. healthcare system. More than 75% of the care for persons with ADRD is provided by family members at home, who need ongoing support to manage the daunting physical and psychological demands of care. A 20+ year randomized controlled trial (RCT) demonstrated the many benefits of a counseling and support intervention for spouse caregivers, the NYU Caregiver Intervention (NYUCI). Most notably, the NYUCI substantially reduced caregiver's depressive symptoms, improved their physical health, and extended the time persons with ADRD remained at home by an average of 1.5 years (Mittelman et al., AG14634, formerly MH42216; See www.nrepp.samhsa.gov/programfulldetails.asp? PROGRAM_ID=122). The intervention is now being widely implemented, but there are barriers that prevent many caregivers from receiving its benefits, including geographic distance; impediments to older adults leaving their homes; and travel considerations for counselors which make it impossible to provide the NYUCI. This innovative Fast Track application has massive implications for social service delivery to older adults, because it will make it possible to delivr an in-person intervention which is already evidenced based to older adult caregivers who cannot currently be served. It will create the online reservation and management technology linking counselors with families as well as the evidence of effectiveness of providing such services via secure video teleconferencing vehicles. The proposed Telehealth Technology for Distance Counseling (TTDC) and related online educational training modules will connect skilled providers to the families of persons with dementia without regard to geographic location. Implications for rural healthcare delivery are particularly persuasive. To our knowledge, this will be the first large-scale TTDC to be developed and rigorously tested with a randomized controlled trial. We hypothesize that such a system, coupled with online training for providers and families on tele- counseling and distance caregiving, will have similar benefits to those achieved with in-person counseling during the original NYUCI RCT. The TTDC will include a scheduling system to link counselors to families at their mutual convenience and assure delivery in a cost-effective manner. The TTDC has the additional potential to transform ADRD care in ethnic and culturally diverse communities by connecting highly trained NYUCI counselors with specialized language and cultural skills to families who would not have access to these resources locally. This innovative technology has strong commercial potential not only for providing effective and efficient supportive services to rural and ethnically diverse populations, but also for a variety of other disease management areas.